Study objectives-To examine whether psychosocial factors at work are related to self rated health in post-communist countries. Design and settings-Random samples of men and women in five communities in four countries were sent a postal questionnaire (Poland, Czech Republic and Lithuania) or were invited to an interview (Hungary). Working subjects (n=3941) reported their self rated health in the past 12 months (5 point scale), their socioeconomic circumstances, perceived control over life, and the following aspects of the psychosocial work environment: job control, job demand, job variety, social support, and eVort and reward at work (to calculate a ratio of eVort/reward imbalance). As the results did not diVer by country, pooled analyses were performed. Odds ratios of poor or very poor health ("poor health") were estimated for a 1 SD increase in the scores of work related factors. Main results-The overall prevalence of poor health was 6% in men and 7% in women. After controlling for age, sex and community, all work related factors were associated with poor health (p<0.05). After further adjustment for perceived control, only two work related factors remained associated with poor health; the odds ratios (95% confidence intervals) for 1 SD increase in the eVort/reward ratio (log transformed) and job variety were 1.51 (1.29, 1.78) and 0.82 (0.73, 1.00), respectively. Further adjustment for all work related factors did not change these estimates. There were no interactions between individual work related factors, but the eVects of job control and social support at work diVered by marital status, and the odds ratio of job demand increased with increasing education. Conclusions-The continuous measure of eVort/reward imbalance at work was a powerful determinant of self rated health in these post-communist populations. Although the cross sectional design does not allow firm conclusions as to causality, this study suggests that the eVect of the psychosocial work environment is not confined to Western populations. (J Epidemiol Community Health 2001;55:624-630)

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The reduction in population blood pressure and improved hypertension control may have contributed substantially to the decrease in cardiovascular disease mortality in the Czech Republic.

Background Compared with Western Europe, the decline in cardiovascular (CV) mortality has been delayed in former communist countries in Europe, including the Czech Republic. We have assessed longitudinal trends in major CV risk factors in the Czech Republic from 1985 to 2016/17, covering the transition from the totalitarian regime to democracy. Methods There were 7 independent cross-sectional surveys for major CV risk factors conducted in the Czech Republic in the same 6 country districts within the WHO

Objective-To analyse socioeconomic differences in serum thiocyanate concentrations among current smokers, and whether such diVerences persist after adjustment for the number of cigarettes smoked. Setting-General population of six districts of the Czech Republic in 1992. Participants-451 male and 282 female current smokers. Main outcome measure-Serum concentration of thiocyanate.Results-There was a clear educational gradient in serum thiocyanate among male smokers; car ownership and crowding were not related to thiocyanate. Age adjusted mean concentrations in men with primary, vocational, secondary, and university education were 168.6, 158.2, 148.2, and 141.8 µmol/l, respectively (p for trend 0.032). Adjustment for the average daily number of cigarettes explained a part of this gradient. Socioeconomic diVerences in serum thiocyanate were not seen in women. Conclusion-The strong gradient in men suggests that smokers from lower socioeconomic groups have a preference for higher smoke intake and so may be more nicotine dependent. This finding, if confirmed, would have important implications for anti-smoking programmes. (Tobacco Control 2000;9:310-312)